<p><strong> </strong><strong>In mCRPC patients who received prior docetaxel chemotherapy either in the mHSPC or mCRPC setting, clinicians may offer cabazitaxel. (<em>Conditional Recommendation; Evidence Level: Grade B</em>)</strong></p>
Discussion
Discussion
<p>Three cytotoxic chemotherapy regimens have been approved by the FDA for treatment of mCRPC: mitoxantrone, docetaxel, and cabazitaxel. Mitoxantrone was not associated with a survival benefit and is generally not recommended for most patients with mCRPC. Cabazitaxel was approved as second line chemotherapy in 2010 based on the results of the TROPIC trial.<sup>24</sup> TROPIC randomized 755 men with mCRPC who had previously received docetaxel chemotherapy and demonstrated median survival of 15.1 months (95% CI: 14.1 to 16.3) in the cabazitaxel group and 12.7 months (11.6 to 13.7) in the mitoxantrone group. The HR for death of men treated with cabazitaxel compared with those taking mitoxantrone was 0.70 (95% CI: 0.59 to 0.83, p<0.0001). There was a clear OS benefit to cabazitaxel chemotherapy after docetaxel.</p>
<p>The FIRSTANA trial was a phase III randomized trial that failed to demonstrate superiority of cabazitaxel over docetaxel as first-line chemotherapy for patients with chemotherapy-naïve metastatic castration-resistant prostate cancer.<sup>128</sup></p>